Senate Bill sb0398c1
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Florida Senate - 2006 CS for SB 398
By the Committee on Health and Human Services Appropriations;
and Senator Saunders
603-2005-06
1 A bill to be entitled
2 An act relating to funding for social services;
3 amending s. 394.457, F.S.; deleting provisions
4 authorizing a reimbursement rate of 100 percent
5 by the Department of Children and Family
6 Services for certain services provided under
7 the Baker Act; amending s. 394.908, F.S.;
8 revising the methodology for distributing funds
9 for certain substance abuse and mental health
10 services; repealing s. 402.33(10), F.S.,
11 relating to provisions authorizing the use of
12 certain excess funds for nonrecurring
13 expenditures incurred in providing direct
14 client services and for certain administrative
15 costs; amending s. 409.1671, F.S.; revising
16 provisions requiring that a statewide risk pool
17 be established for community-based providers,
18 their subcontractors, and providers of other
19 social services who contract with the
20 Department of Children and Family Services;
21 requiring that the department develop a plan,
22 in consultation with the Florida Coalition for
23 Children, Inc., regarding the long-term use and
24 structure of the risk pool; deleting certain
25 restrictions governing payments for insolvency;
26 authorizing the department to issue an
27 interest-free loan to the Florida Coalition for
28 Children, Inc.; providing an effective date.
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30 Be It Enacted by the Legislature of the State of Florida:
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1 Section 1. Subsection (3) of section 394.457, Florida
2 Statutes, is amended to read:
3 394.457 Operation and administration.--
4 (3) POWER TO CONTRACT.--The department may contract to
5 provide, and be provided with, services and facilities in
6 order to carry out its responsibilities under this part with
7 the following agencies: public and private hospitals;
8 receiving and treatment facilities; clinics; laboratories;
9 departments, divisions, and other units of state government;
10 the state colleges and universities; the community colleges;
11 private colleges and universities; counties, municipalities,
12 and any other governmental unit, including facilities of the
13 United States Government; and any other public or private
14 entity which provides or needs facilities or services. Baker
15 Act funds for community inpatient, crisis stabilization,
16 short-term residential treatment, and screening services must
17 be allocated to each county pursuant to the department's
18 funding allocation methodology. Notwithstanding the provisions
19 of s. 287.057(5)(f), contracts for community-based Baker Act
20 services for inpatient, crisis stabilization, short-term
21 residential treatment, and screening provided under this part,
22 other than those with other units of government, to be
23 provided for the department must be awarded using competitive
24 sealed bids when the county commission of the county receiving
25 the services makes a request to the department's district
26 office by January 15 of the contracting year. The district
27 shall not enter into a competitively bid contract under this
28 provision if such action will result in increases of state or
29 local expenditures for Baker Act services within the district.
30 Contracts for these Baker Act services using competitive
31 sealed bids will be effective for 3 years. Services contracted
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1 for by the department may be reimbursed by the state at a rate
2 up to 100 percent. The department shall adopt rules
3 establishing minimum standards for such contracted services
4 and facilities and shall make periodic audits and inspections
5 to assure that the contracted services are provided and meet
6 the standards of the department.
7 Section 2. Section 394.908, Florida Statutes, is
8 amended to read:
9 394.908 Substance abuse and mental health funding
10 equity; distribution of appropriations.--In recognition of the
11 historical inequity among service districts of the former
12 Department of Health and Rehabilitative Services in the
13 funding of substance abuse and mental health services for the
14 districts and region, and in order to rectify this inequity
15 and provide for equitable funding in the future throughout the
16 state, the following funding process shall be used adhered to:
17 (1) Funding thresholds for substance abuse and mental
18 health services in each of the current districts, statewide,
19 shall be established based on the current number of persons in
20 need per district of substance abuse and mental health
21 services, respectively.
22 (2) "Persons in need" means those persons who fit the
23 profile of the respective target populations and require
24 mental health or substance abuse services.
25 (3) Seventy-five percent of Any additional funding
26 beyond the 2005-2006 1996-1997 fiscal year base appropriation
27 for alcohol, drug abuse, and mental health services shall be
28 allocated to districts for substance abuse and mental health
29 services based on:
30 (a) Epidemiological estimates of disabilities that
31 which apply to the respective target populations.
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1 (b) A pro rata share distribution that ensures
2 districts below the statewide average funding level per person
3 in each target population of "persons in need" receive funding
4 necessary to achieve equity.
5 (4) The remaining 25 percent shall be allocated based
6 on the number of persons in need of substance abuse and mental
7 health services per district without regard to current funding
8 levels.
9 (4)(5) Target populations for persons in need shall be
10 displayed for each district and distributed concurrently with
11 the approved operating budget. The display by target
12 population shall show: The annual number of persons served
13 based on prior year actual numbers, the annual cost per person
14 served, the number of persons served by service cost center,
15 and the estimated number of the total target population for
16 persons in need.
17 (5)(6) The annual cost per person served shall be
18 defined as the total actual funding for each target population
19 divided by the number of persons served in the target
20 population for that year.
21 (7) Commencing on July 1, 1998, all additional funding
22 pursuant to this section shall be performance-based.
23 (8) For fiscal year 2004-2005 only, and
24 notwithstanding the provisions of this section, all new funds
25 received in excess of fiscal year 2003-2004 recurring
26 appropriations shall be allocated in accordance with the
27 provisions of the General Appropriations Act; however, no
28 district shall receive an allocation of recurring funds less
29 than its initial approved operating budget, plus any
30 distributions of lump sum appropriations or reductions in
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1 unfunded budget, for fiscal year 2003-2004. This subsection
2 expires July 1, 2005.
3 Section 3. Subsection (10) of section 402.33, Florida
4 Statutes, is repealed.
5 Section 4. Subsection (7) of section 409.1671, Florida
6 Statutes, is amended to read:
7 409.1671 Foster care and related services;
8 outsourcing.--
9 (7) The Florida Coalition for Children, Inc., in
10 consultation with The department, shall develop a plan, in
11 consultation with the Florida Coalition for Children, Inc.,
12 based on an independent actuarial study regarding the
13 long-term use and structure of a statewide community-based
14 care risk pool for the protection of eligible lead
15 community-based providers, their subcontractors, and providers
16 of other social services who contract directly with the
17 department. The plan must also outline strategies to maximize
18 federal earnings as they relate to the community-based care
19 risk pool. At a minimum, the plan must allow for the use of
20 federal earnings received from child welfare programs to be
21 allocated to the community-based care risk pool by the
22 department, which earnings are determined by the department to
23 be in excess of the amount appropriated in the General
24 Appropriations Act. The plan must specify the necessary steps
25 to ensure the financial integrity and industry-standard risk
26 management practices of the community-based care risk pool and
27 the continued availability of funding from federal, state, and
28 local sources. The plan must also include recommendations that
29 permit the program to be available to entities of the
30 department providing child welfare services until full
31 conversion to community-based care takes place. The final plan
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1 shall be submitted to the department and then to the Executive
2 Office of the Governor and the Legislative Budget Commission
3 for formal adoption before January 1, 2005. Upon approval of
4 the plan, the department may expend funds from the risk pool
5 pursuant to the provisions of the plan. by all parties, the
6 department shall issue an interest-free loan that is secured
7 by the cumulative contractual revenue of the community-based
8 care risk pool membership, and the amount of the loan shall
9 equal the amount appropriated by the Legislature for this
10 purpose. The plan shall provide for a governance structure
11 that assures the department the ability to oversee the
12 operation of the community-based care risk pool at least until
13 this loan is repaid in full.
14 (a) The purposes for which the community-based care
15 risk pool shall be used include, but are not limited to:
16 1. Significant changes in the number or composition of
17 clients eligible to receive services.
18 2. Significant changes in the services that are
19 eligible for reimbursement.
20 3. Scheduled or unanticipated, but necessary, advances
21 to providers or other cash-flow issues.
22 4. Proposals to participate in optional Medicaid
23 services or other federal grant opportunities.
24 5. Appropriate incentive structures.
25 6. Continuity of care in the event of failure,
26 discontinuance of service, or financial misconduct by a lead
27 agency.
28 7. Payment for time-limited technical assistance and
29 consultation to lead agencies in the event of serious
30 performance or management problems.
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1 8. Payment for meeting all traditional and
2 nontraditional insurance needs of eligible members.
3 9. Significant changes in the mix of available funds.
4 (b) After approval of the plan in the 2004-2005 fiscal
5 year and annually thereafter, the department may also request
6 in its annual legislative budget request, and the Governor may
7 recommend, that the funding necessary to carry out paragraph
8 (a) be appropriated to the department. Subsequent funding of
9 the community-based care risk pool shall be supported by
10 premiums assessed to members of the community-based care risk
11 pool on a recurring basis. The community-based care risk pool
12 may invest and retain interest earned on these funds. In
13 addition, the department may transfer funds to the
14 community-based care risk pool as available in order to ensure
15 an adequate funding level if the fund is declared to be
16 insolvent and approval is granted by the Legislative Budget
17 Commission. Such payments for insolvency shall be made only
18 after a determination is made by the department or its actuary
19 that all participants in the community-based care risk pool
20 are current in their payments of premiums and that assessments
21 have been made at an actuarially sound level. Such payments by
22 participants in the community-based care risk pool may not
23 exceed reasonable industry standards, as determined by the
24 actuary. Money from this fund may be used to match available
25 federal dollars. Dividends or other payments, with the
26 exception of legitimate claims, may not be paid to members of
27 the community-based care risk pool until the loan issued by
28 the department is repaid in full. Dividends or other payments,
29 with the exception of legitimate claims and other purposes
30 contained in the approved plan, may not be paid to members of
31 the community-based care risk pool unless, at the time of
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1 distribution, the community-based care risk pool is deemed
2 actuarially sound and solvent. Solvency shall be determined by
3 an independent actuary contracted by the department. The plan
4 shall be developed in consultation with the Office of
5 Insurance Regulation.
6 1. Such funds shall constitute partial security for
7 contract performance by lead agencies and shall be used to
8 offset the need for a performance bond. Subject to the
9 approval of the plan, the community-based care risk pool shall
10 be managed by the Florida Coalition for Children, Inc., or the
11 designated contractors of the Florida Coalition for Children,
12 Inc. Nonmembers of the community-based care risk pool may
13 continue to contract with the department but must provide a
14 letter of credit equal to one-twelfth of the annual contract
15 amount in lieu of membership in the community-based care risk
16 pool.
17 2. The department may separately require a bond to
18 mitigate the financial consequences of potential acts of
19 malfeasance, misfeasance, or criminal violations by the
20 provider.
21 (c) The department may issue an interest-free loan to
22 the Florida Coalition for Children, Inc., for the purpose of
23 creating a self-insurance program. Such loan shall be secured
24 by the cumulative contractual revenue of the community-based
25 care lead agencies participating in the self-insurance
26 program. The amount of the loan shall be in an amount equal to
27 the amount appropriated by the Legislature for this purpose.
28 Section 5. This act shall take effect July 1, 2006.
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1 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
2 Senate Bill 398
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4 Clarifies that Baker Act services are subject to 25 percent
local participation.
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Modifies the method of allocating substance abuse and mental
6 health funding to specify that 100 percent of all
appropriation increases to these programs shall be distributed
7 based on equity.
8 Removes statutory restrictions on the utilization of fees
collected by the Department of Children and Family Services
9 (DCF) in excess of the appropriation.
10 Reassigns responsibility for the operation and maintenance of
the community-based care risk pool from the Florida Coalition
11 for Children, Inc., to DCF.
12 Revises the requirements for operating and managing the
community-based care risk pool.
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Mandates DCF to develop a long-range plan, inconsultation with
14 the Florida Coalition for Children, Inc., and to submit the
plan for approval by the Office of the Governor and the
15 Legislative Budget Commission.
16 Authorizes DCF to issue an interest-free loan to the Florida
Coalition for Children, Inc., for the purpose of operating a
17 self-insurance program.
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